Why Do Surgeons Miss Malignancies in Patients with Acute Abdominal Pain?

• Published in: Anticancer research Vol. 26; no. 5B; pp. 3675 - 3678
• Main Authors: LAURELL, H, HANSSON, L.-E, GUNNARSSON, U
• Format: Journal Article
• Language: English
• Published: Attiki International Institute of Anticancer Research 01-09-2006
• Subjects: abdominal malignancy; Abdominal Neoplasms - diagnosis; Abdominal Pain - etiology; Abdominal Pain - surgery; acute abdominal pain; Adult; Aged; Aged, 80 and over; Biological and medical sciences; cancer; Cancer and Oncology; cancer diagnosis; Cancer och onkologi; carcinoma; clinical presentation; Cohort Studies; Diagnostic Errors; diverticulitis; Female; General Surgery - manpower; Humans; lymphoma; Male; Medical sciences; MEDICIN; MEDICINE; Middle Aged; population; Sweden; Tumors; Sweden; Human; Acute; abdominal malignancy; cancer diagnosis; Malignancy; Malignant tumor; Surgeon; Abdomen; Acute abdominal pain; Cancerology; Pain; Diagnosis; Cancer
• ISSN: 0250-7005; 1791-7530; 1791-7530

Background: The aim of this study was to characterize patients seeking medical advice for acute abdominal pain who were later
diagnosed with an intra-abdominal malignancy. Patients and Methods: Patients with acute abdominal pain were registered between
1997 and 2000, employing a detailed schedule comprising 111 parameters. The diagnoses (n=2395 patients) were re-evaluated
one year later. Results: A total of 66 patients (2.8%) were found to have an intra-abdominal malignancy at follow-up, of whom
37 cases had been undetected at discharge. Malignancy of the liver, biliary tract and pancreas constituted 30% and colorectal
cancer 32% of the tumours undetected at discharge. Constipation, intestinal obstruction and non-specific abdominal pain (NSAP)
were the most common preliminary diagnoses in patients among whom abdominal malignancy was later detected. Conclusion: Except
for age and pain duration, the history and clinical investigation provide few clues to suggest an abdominal malignancy in
patients with acute abdominal pain. NSAP, of unknown or known etiology, including constipation, should be suspected as a possible
sign of abdominal malignancy in all patients over 50 years of age.